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"Peri" menopause -

Perimenopause literally means "around" menopause. It's the time when your body is making the transition to menopause, marking the end of the reproductive years.

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Symptom onset -

Women experience perimenopause differently, and its onset will vary from person to person. For many, sometime in their forties is when the symptoms will first occur.

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Symptom onset -

However, for some, symptoms such as periods becoming more irregular or the start of hot flashes could onset as early as their mid-thirties.

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Levels of estrogen -

During perimenopause, the levels of estrogen in your body rise and fall unevenly. This hormonal fluctuation is what causes symptoms to arise.

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Levels of estrogen -

As hormone levels change, your cycles can become shorter or longer. You might begin to have cycles where your ovaries don't ovulate.

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Irregularity -

Unpredictable ovulation is a sign of perimenopause. If your cycle has a persistent change of more than seven days, you could be in perimenopause. Going more than 60 days between periods can indicate you're in the late stages.

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Hot flashes -

The onset of hot flashes—of varying length, intensity, and frequency—s perhaps one of the most well-known symptoms of perimenopause.

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Fatigue -

It's not uncommon for hot flashes to interrupt sleep patterns. However, even without them you can experience disruption to your sleep as perimenopause begins.

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Mood changes -

The domino effect of hormone fluctuations, hot flashes, and a lack of sleep can cause mood problems during perimenopause.

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Mood changes -

The likelihood of mood swings and feelings of irritability is higher during this time in your life, as is your risk of depression.

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Vaginal problems -

As estrogen levels decrease, your vagina loses lubrication and elasticity. As a result, intercourse can become more painful.

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Bladder problems -

Losing tissue and tone can also lead to bladder problems during perimenopause, such as incontinence. Your vulnerability to urinary tract infections also increases.

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Reduced fertility -

During perimenopause, your body is beginning to ovulate less. With this irregularity, your ability to conceive decreases.

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Reduced fertility -

As long as you still have periods, it's still possible to become pregnant. If that's something you don't want, continue to use birth control methods.

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Loss of bone density -

Estrogen slows down the natural breakdown of bone. As estrogen decreases, you start to lose bone faster than you can replace it, increasing your risk of developing osteoporosis.

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Cholesterol level changes -

Estrogen plays a role in keeping cholesterol low. Declining estrogen can mean you see an increase in LDL "bad" cholesterols, and a decrease in HDL "good" cholesterols. LDLs increase your risk of heart disease.

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When to see a doctor -

Symptoms can be subtle and gradual, worsening over time. At first, you might not realize what's happening is perimenopause.

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When to see a doctor -

Some women don't experience many symptoms at all. However, if your symptoms are interfering with your well-being, or you feel concerned, it's time to see a doctor.

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Risk factor: smoking -

There's evidence to suggest certain factors make it more likely you'll begin perimenopause sooner. For instance, symptoms onset one to two years earlier in women who smoke versus those who don't.

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Family history -

If the women in your family have a history of perimenopause symptoms beginning at an earlier age, there's a higher chance you will, too.

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Cancer treatment -

If you've undergone chemotherapy or pelvic radiation treatment for cancer, you're more likely to experience earlier perimenopause.

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Hysterectomy -

If you undergo a hysterectomy to remove your uterus, but your ovaries remain intact, this usually does not cause menopause. Your ovaries continue to produce estrogen, even though you no longer have periods.

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Hysterectomy -

However, perimenopause might begin sooner. If you've had surgery to remove an ovary, there's a chance the remaining ovary might stop working earlier.

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Complications -

Extremely heavy bleeding (where you have to change a pad or tampon more than every two hours), bleeding that lasts longer than seven days, and bleeding that occurs between periods are signs of a reproductive problem; you should contact your doctor.

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Treatment: use a lubricant -

Water-based lubricants and moisturizers can make life more comfortable. Staying active with your partner can help ease symptoms, as it increases blood flow to the area.

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Make time to de-stress -

Making time in your day for deep belly breathing, yoga, meditation, or active mindfulness can help reduce stress during this transitional time.

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Good nutrition -

Consuming enough calcium-rich and heart-healthy foods should be a priority, to support your body's nutrient needs during this time. You might need to take a vitamin D supplement to help with calcium absorption, if you live somewhere that has less sunlight.

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Black cohosh -

Some women find black cohosh helps with reducing hot flashes. However, there's not enough evidence-based research to back this up. Consult your doctor before taking herbs or herbal supplements.

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Flaxseed -

Phytoestrogens occur naturally in certain foods, like flaxseed, soybeans, legumes, and red clover. Again, studies conflict about their efficacy, so exercise caution before taking/consuming anything new.

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Track and list your symptoms -

Keep track of your cycles, symptoms, family history, and any medications (including vitamin and herb supplements) you're taking. That way, if you need to see your doctor, you have all the relevant information ready. 

Sources: (Mayo Clinic) (Harvard Health) (Web MD) (Johns Hopkins Medicine)

See also: Celebrity women open up about menopause

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